Jade Alexa Pellerito, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

056012576 Issued in IL

Practice address

11411 183Rd St
Orland Park, IL 60467

Phone

(708) 478-1820

NPI assigned

Jul 17, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Functional Living Children'S Therapy PLLC

  • Pediatric Occupational Therapist
  • Orland Park, IL
  • NPI 1063358042

  Pediatrics

  NPD Authorized official
• Bautz Developmental Intervention Inc

  • Physical Therapist
  • Orland Park, IL
  • NPI 1376530055
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1831675412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13937 JOHN HUMPHREY DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604622079",
            "telephone_number": "708-341-8318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11411 183RD ST",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "60467",
            "telephone_number": "708-478-1820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1811 W Diehl Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605636400",
            "country_code": "US",
            "telephone_number": "630-428-1595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PELLERITO",
        "first_name": "JADE",
        "middle_name": "ALEXA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-17",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IL",
            "license": "056012576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Pearson, LPC
• Karen A Peck
• Jamie Pedroza, RBT
• Pamela Pedziwiatr, SPEECH-LANGUAGE PATH
• Kaylee Pellack
• Janet Pepich, PT
• Dmitriy Peresada, MD
• Perfect Fit Footwear
• Performance Foot and Ankle Center LLC
• Performance Physical Therapy of Palos Park

• Pediatric Occupational Therapist in Orland Park, IL
• Providers in Orland Park, IL by specialty
• Pediatric Occupational Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.